Method for controlling flow in a bodily organ

• US 20090248109A1
• Filed: 10/14/2008
• Published: 10/01/2009
• Est. Priority Date: 10/11/2007
• Status: Active Grant

• Current Assignee: Kirk Promotion Ltd.
• Original Assignee: Milux Holding SA
• Inventors: Forsell, Peter
• Granted Patent: US 9,833,619 B2
• Time in Patent Office: Days
• US Class Current: 607/39
• CPC Class Codes: A61F 2/00 Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents as cosmetic articles, see the relevant subclasses, e.g. wigs, hair pieces, A41G3/00, A41G5/00; artificial nails A45D31/00; dental prostheses A61C13/00; materials for prostheses A61L27/00; artificial hearts A61M60/00; artificial kidneys A61M1/14
• CPC Class Codes: A61F 2/004 inflatable
• CPC Class Codes: A61M 2205/8243 by induction
• CPC Class Codes: A61M 60/148 in line with a blood vessel using resection or like techniques, e.g. permanent endovascular heart assist devices
• CPC Class Codes: A61M 60/161 mechanically acting upon the outside of the patient's blood vessel structure, e.g. compressive structures placed around a vessel
• CPC Class Codes: A61M 60/289 Devices for mechanical circulatory actuation assisting the residual heart function by means mechanically acting upon the patient's native heart or blood vessel structure, e.g. direct cardiac compression [DCC] devices
• CPC Class Codes: A61N 1/0507 Electrodes for the digestive system
• CPC Class Codes: A61N 1/36007 of urogenital or gastrointestinal organs, e.g. for incontinence control
• CPC Class Codes: A61N 1/3605 Implantable neurostimulators for stimulating central or peripheral nerve system
• CPC Class Codes: A61N 1/36514 controlled by a physiological quantity other than heart potential, e.g. blood pressure controlled by two or more physical parameters A61N1/36585
• CPC Class Codes: A61N 1/36564 controlled by blood pressure
• CPC Class Codes: A61N 1/36578 controlled by mechanical motion of the heart wall, e.g. measured by an accelerometer or microphone
• CPC Class Codes: A61N 1/3787 from an external energy source
• CPC Class Codes: A61N 1/403 for thermotherapy, e.g. hyperthermia

Abstract

There is provided a method for treating a male impotent patient comprising stimulating at least one portion of the patient'"'"'s normal penile tissue or the prolongation thereof to at least restrict the blood flow leaving the penis to achieve erection. To improve the erection effect the method further comprises gently constricting the penile portion or the prolongation thereof to restrict the venous blood flow in the penile portion, and then stimulating the constricted penile portion to cause contraction of the penile portion to at least further restrict the blood flow leaving the penis to achieve erection.

Claims

1. A method for treating a male impotent patient, the method comprising stimulating at least one portion of the patient'"'"'s normal penile tissue or the prolongation thereof to at least restrict the blood flow leaving the penis to achieve erection.

2. The method according to claim 1, further comprising:

a) gently constricting the penile portion or the prolongation thereof to restrict the venous blood flow in the penile portion, and then

b) stimulating the constricted penile portion to cause contraction of the penile portion to at least further restrict the blood flow leaving the penis to achieve erection.

3. The method according to claim 2, wherein the penile portion is constricted, so that the venous blood flow in the penile portion at least is restricted and the constricted penile portion is stimulated to at least further restrict the venous blood flow in the penile portion.

4. The method according to claim 2, wherein the penile portion is constricted to a constricted state, in which the blood circulation in the constricted penile portion is substantially unrestricted and the venous blood flow in the penile portion is at least restricted, and the constricted penile portion is stimulated when it is in the constricted state to at least further restrict the venous blood flow in the penile portion.

5. The method according to claim 2, wherein the constriction of the penile portion is calibrated by stimulating the penile portion while adjusting the constriction of the penile portion until the desired restriction of the venous blood flow in the penile portion is obtained.

6. The method according to claim 2, wherein step (b) is not performed while step (a) is performed.

7. The method according to claim 2, wherein step (a) is performed by constricting the penile portion, so that the venous blood flow in the penile portion is restricted but not stopped, and step (b) is performed by stimulating the constricted penile portion to cause contraction thereof, so that the venous blood flow in the penile portion is further restricted but not stopped.

8. The method according to claim 7, further comprising sensing a physical parameter of the patient and adjusting the intensity of the stimulation of the penile portion in response to the sensed parameter.

9. The method according to claim 7, further comprising (c) ceaseing stimulating the penile portion to increase the venous blood flow in the penile portion, and (d) releasing the penile portion to restore the venous blood flow in the penile portion.

11. The method according to claim 2, wherein step (a) is performed by constricting the penile portion, so that the venous blood flow in the penile portion is restricted but not stopped, and step (b) is performed by stimulating the constricted penile portion to cause contraction thereof, so that the venous blood flow in the penile portion is stopped.

12. The method according to claim 11, further comprising (c) ceaseing stimulating the penile portion to allow venous blood flow in the penile portion, and (d) releasing the penile portion to restore the venous blood flow in the penile portion.

14. The method according to claim 11, further comprising sensing a physical parameter of the patient and adjusting the intensity of the stimulation of the penile portion in response to the sensed parameter, wherein the intensity of the stimulation of the penile portion is increased so that the venous blood flow in the penile portion remains stopped when a pressure increase occurs in the lumen, wherein the physical Parameter relates to the pressure in the lumen, and the stimulation of the penile portion is controlled in response to the sensed Parameter, and wherein the physical parameter is a pressure in the patient'"'"'s body.

18. The method according to claim 2, wherein step (a) is performed by constricting the penile portion, so that the venous blood flow in the penile portion is substantially stopped, and step (b) is performed by stimulating the constricted penile portion to cause contraction thereof, so that the venous blood flow in the penile portion is completely stopped.

19. The method according to claim 18, further comprising (c) ceaseing stimulating the penile portion to allow venous blood flow in the penile portion, and (d) releasing the penile portion to restore the venous blood flow in the penile portion.

21. The method according to claim 18, further comprising sensing a physical parameter of the patient and adjusting the intensity of the stimulation of the penile portion in response to the sensed parameter, wherein the intensity of the stimulation of the penile portion is increased so that the venous blood flow in the penile portion remains stopped when a pressure increase occurs in the lumen, wherein the physical parameter relates to the pressure in the lumen and the stimulation of the penile portion is controlled in response to the sensed parameter, and wherein the physical parameter is a pressure in the patient'"'"'s body.

25. The method according to claim 2, wherein step (a) is performed by constricting the penile portion, so that the venous blood flow in the penile portion is stopped.

26. The method according to claim 25, further comprising (d) releasing the penile portion to restore the venous blood flow in the penile portion.

27. The method according to claim 25, wherein step (b) is performed by stimulating the constricted penile portion to cause contraction thereof, so that the venous blood flow in the penile portion remains stopped when a pressure increase occurs in the lumen, further comprising sensing a physical parameter of the patient'"'"'s that relates to the pressure in the lumen, and controlling the stimulation of the penile portion in response to the sensed parameter, wherein the physical parameter is a pressure in the patient'"'"'s body.

30. The method according to claim 2, further comprising sensing a physical parameter of the patient and automatically controlling at least one of the constriction and stimulation of the penile portion in response to the sensed parameter.

32. The method according to claim 2, further comprising providing a constriction device for performing step (a) and a stimulation device for performing step (b), and forming the constriction and stimulation devices in an operable constriction/stimulation unit a control device that controls at least one of the constriction and stimulation devices.

33. The method according to claim 32, further comprising providing a control device that controls the constriction/stimulation unit, and operating the control device from outside the patient'"'"'s body.

35. The method according to claim 33, wherein the control device comprises a hand-held wireless remote control that is operated by the patient, or a manually operable switch for switching on and off at least one of the constriction and stimulation devices, the method further comprising subcutaneously implanting the switch in the patient and manually operating the implanted switch from outside the patient'"'"'s body.

37. The method according to claim 33, further comprising using the control device to wirelessly control at least one of the constriction and stimulation devices in a non-magnetic manner.

39. The method according to claim 1, wherein the stimulation step is performed by intermittently and individually stimulating different areas of the penile portion so that at least two of the areas are stimulated at different points of time, wherein the stimulation step is performed by intermittently stimulating each area of the different areas of the wall portion during successive time periods, each time period being short enough to maintain over time satisfactory blood circulation in the area until the laps of the time period, and wherein the stimulation step is performed by intermittently stimulating the areas of the wall portion so that an area of the wall portion that currently is not stimulated has time to restore substantially normal blood circulation before it is stimulated again.

42. The method according to claim 1, wherein the stimulation step is performed by stimulating one or more of different areas of the penile portion at a time.

43. The method according to claim 42, wherein the stimulation step is performed by sequentially stimulating the different areas of the penile portion, or by shifting the stimulation from one area to another over time, or by cyclically propagating the stimulation of the areas along the wall portion in the same or opposite direction of the flow in the patient'"'"'s penile portion in accordance with a determined stimulation pattern.

47. The method according to claim 1, wherein the stimulation step is performed by stimulating the penile portion with cyclically varying stimulation intensity.

49. The method according to claim 1, wherein the stimulation step is performed by intermittently and individually stimulating different areas of the penile portion with pulses.

51. The method according to claim 49, wherein the pulses form pulse trains and at least one of the following steps is performed:

varying the pulse amplitudes of the pulses of the pulse trains;

varying the frequency of the pulses of the pulse trains;

varying the frequency of the pulse trains; and

varying the number of pulses of each pulse train.

52. The method according to claim 49, wherein the pulses form pulse trains and at least one of the following steps is performed:

varying the off time periods between the individual pulses of each pulse train;

varying the off time periods between the pulse trains;

varying the width of each pulse of the pulse trains; and

varying the length of each pulse train.

58. The method according to claim 49, wherein the pulses form pulse trains and each off time period between the pulse trains is kept long enough to restore substantially normal blood circulation in each area when the area is not stimulated during the off time periods.

62. The method according to claim 1, wherein the stimulation step is performed by electrically stimulating different areas of the penile portion with electric pulses.

64. The method according to claim 62, wherein the penile portion includes muscle fibers, and the stimulation step is performed by stimulating the penile portion including the muscle fibers with the electric pulses.

65. The method according to claim 62, further comprising providing at least one electrical element engaging the penile portion.

66. The method according to claim 65, further comprising providing a plurality of electrical elements engaging the penile portion.

67. The method according to claim 66, further comprising placing the electrical elements in a fixed orientation relative to one another and providing a structure holding the electrical elements in the fixed orientation, wherein the electrical elements form an elongate pattern of electrical elements with two opposite short ends, and further comprising applying the structure on the penile portion so that the elongate pattern of electrical elements extends along the penile portion in the direction of the flow in the patient'"'"'s lumen and the elements abut the respective areas of the penile portion.

71. The method according to claim 66, further comprising electrically energizing the electrical elements, wherein each electrical element is cyclically energized with electric pulses.

72. The method according to claim 71, wherein the electrical elements are energized so that a number or groups of the electrical elements are energized at the same time.

73. The method according to claim 71, wherein the electrical elements are energized one at a time in sequence or groups of the electrical elements are sequentially energized, either randomly or in accordance with a predetermined pattern.

74. The method according to claim 71, further comprising applying the electrical elements on the penile portion so that the electrical elements form an elongate pattern of electrical elements extending along the penile portion in the direction of the flow in the patient'"'"'s lumen and the elements abut the respective areas of the penile portion.

75. The method according to claim 74, wherein the electrical elements are successively energized along the elongate pattern of electrical elements.

76. The method according to claim 75, wherein the electrical elements are successively energized along the elongate pattern of electrical elements in the same or opposites direction that of the flow in the patient'"'"'s lumen.

77. The method according to claim 75, wherein the electrical elements are successively energized along the elongate pattern of electrical elements from a position substantially at the center of the constricted wall portion towards both ends of the elongate pattern of electrical elements.

78. The method according to claim 75, wherein the electrical elements are energized so that electrical elements currently energized form at least one group of adjacent energized electrical elements.

79. The method according to claim 78, wherein the elements in the group of energized electrical elements form a path of energized electrical elements, and wherein the path of energized electrical elements extends at least in part or completely around the penile portion.

80. The method according to claim 78, wherein the group of adjacent energized electrical elements comprises one or more electrical elements.

81. The method according to claim 80, wherein the group of adjacent energized electrical elements comprises two electrical elements provided mutually on opposite sides of the penile portion.

82. The method according to claim 78, wherein the electrical elements are applied on the patient'"'"'s penile portion in a series of groups of elements extending along the patient'"'"'s penile portion in the direction of flow in the patient'"'"'s penile portion, and wherein the groups of electrical elements in the series of groups are successively energized in the same or opposite direction of the flow in the patient'"'"'s penile portion.

83. The method according to claim 80, wherein the group of adjacent energized electrical elements comprises three electrical elements extending around the patient'"'"'s penile portion.

84. The method according to claim 74, wherein the electrical elements are applied on the penile portion in a series of groups of elements extending along the penile portion.

85. The method according to claim 84, wherein the groups of electrical elements in the series of groups are successively energized along the penile portion.

87. The method according to claim 84, wherein the electrical elements of each group of electrical elements form a path of elements extending at least in part or completely around the penile portion.

89. The method according to claim 84, wherein the electrical elements of each group of electrical elements form two paths of elements extending on mutual sides of the penile portion, and wherein the two paths of electrical elements of each group of elements extend at least substantially transverse to the direction of flow in the patient'"'"'s penile portion.

91. The method according to claim 2, wherein step (b) is performed by thermally stimulating the penile portion.

93. The method according to claim 91, wherein step (a) is performed to at least restrict the venous blood flow in the penile portion, and step (b) is performed by cooling the penile portion to cause contraction of the penile portion, so that the venous blood flow in the penile portion is at least further restricted, or at least further restricted but not stopped, or stopped.

96. The method according to claim 93, further comprising heating the penile portion, when the penile portion is constricted and contracted, to cause expansion of the penile portion.

108. The method according to claim 32, further comprising calibrating the constriction of the penile portion by controlling the stimulation device to stimulate the penile portion while controlling the constriction device to adjust the constriction of the penile portion until the desired restriction of the venous blood flow in the penile portion is obtained.

109. The method according to claim 32, further comprising implanting at least one sensor and controlling by the control device at least one of the constriction and stimulation devices in response to signals from the sensor.

110. The method according to claim 109, wherein at least one physical parameter of the patient is directly or indirectly sensed by the sensor, the sensor comprising a pressure sensor that senses a pressure in the patient'"'"'s body, further comprising controlling the constriction device by the control device to change the constriction of the patient'"'"'s wall portion in response to the pressure sensor sensing a predetermined value.

111. The method according to claim 109, further comprising implanting in the patient a medical implant, wherein at least one functional parameter of the medical implant is directly or indirectly sensed by the sensor.

114. The method according to claim 109, wherein the control device comprises an internal control unit, further comprising implanting in the patient the internal control unit and directly controlling by the internal control unit at least one of the constriction and stimulation devices in response to signals from the sensor.

115. The method according to claim 109, wherein the control device comprises an external control unit outside the patient'"'"'s body, further comprising controlling by the external control unit at least one of the constriction and stimulation devices in response to signals from the sensor.

116. The method according to claim 109, wherein the control device produces an indication in response to signals from the sensor, the indication comprising a sound signal or displayed information.

118. The method according to claim 2, wherein step (a) is performed by mechanically or hydraulically constricting the wall portion.

119. The method according to claim 118, wherein step (a) is performed by mechanically or hydraulically constricting the wall portion in a non-magnetic and/or non-manual manner.

120. The method according to claim 118, wherein step (a) is performed by constricting the penile portion so that the through-flow area of the blood vessel passageway assumes a size in the constricted state small enough to cause the venous blood flow in the penile portion to stop when step (b) is performed.

121. The method according to claim 118, wherein step (a) is performed by bending the penile portion, or clamping the penile portion between at least two elements positioned on different sides of the penile portion, or clamping the penile portion between an element and the bone or tissue of the patient, or rotating at least two elements positioned on different sides of the penile portion, or clamping the penile portion between at least two articulated clamping elements positioned on different sides of the penile portion.

126. The method according to claim 118, further comprising implanting in the patient a main reservoir containing a predetermined amount of hydraulic fluid and a constriction device engaging the penile portion and having an expandable cavity, wherein step (a) is performed by distributing hydraulic fluid from the main reservoir to increase the volume of the cavity to constrict the penile portion.

127. The method according to claim 126, wherein the main reservoir comprises first and second wall portions, and step (a) is performed by displacing the first and second wall portions towards each other to decrease the volume of the main reservoir, so that fluid is distributed from the main reservoir to the cavity, and wherein at least one of a magnetic device, a hydraulic device or an electric control device displaces the first and second wall portions of the main reservoir toward each other.

129. The method according to claim 126, further comprising implanting a reverse servo that distributes hydraulic fluid from the main reservoir to the cavity.

130. The method according to claim 129, wherein the main reservoir comprises first and second wall portions, and the reverse servo displaces the first and second wall portions towards each other to decrease the volume of the main reservoir, so that fluid is distributed from the main reservoir to the cavity, and wherein the reverse servo comprises an expandable servo reservoir containing servo fluid and having first and second wall portions, which are displaceable relative to each other in response to a change in the volume of the expandable servo reservoir, and the first and second wall portions of the servo reservoir are operatively connected to the first and second wall portions of the main reservoir, so that the volume of the main reservoir is changed when the volume of the servo reservoir is changed.

132. The method according to claim 130, further comprising dimensioning the servo and main reservoirs so that when the volume of the servo reservoir is changed by a relatively small amount of servo fluid, the volume of the main reservoir is changed by a relatively large amount of hydraulic fluid.

133. The method according to claim 130, wherein the first and second wall portions of the servo reservoir are displaced relative to each other by manual manipulation.

135. The method according to claim 130, wherein the reverse servo comprises a fluid supply reservoir hydraulically connected to the servo reservoir to form a closed conduit system for the servo fluid.

136. The method according to claim 126, further comprising implanting in the patient a pump that pumps fluid between the main reservoir and the cavity.

137. The method according to claim 136, wherein the pump comprises a first activation member that activates the pump to pump fluid from the main reservoir to the cavity and a second activation member that activates the pump to pump fluid from the cavity to the main reservoir.

139. The method according to claim 137 wherein at least one of the activation members operates when subjected to an external predetermined pressure.

140. The method according to claim 137, wherein at least one of the first and second activating members are operated by a magnetic device, a hydraulic device, or an electric control device.

141. The method according to claim 136, further comprising implanting a fluid conduit between the pump and the cavity, the main reservoir forming part of the conduit conduit and the conduit and pump being devoid of any non-return valve, wherein the main reservoir forms a fluid chamber with a variable volume, step (a) is performed by reducing the volume of the chamber so that fluid is pumped from the chamber to the cavity and the pump comprises a movable wall of the main reservoir for changing the volume of the chamber, the method further comprising implanting a motor for driving the pump.

147. The method according to claim 32, further comprising transmitting wireless energy from outside the patient'"'"'s body to inside the patient'"'"'s body and using the transmitted wireless energy in connection with the operation of at least one of the constriction and stimulation devices.

148. The method according to claim 147, further comprising directly using the wireless energy in connection with the operation of at least one of the constriction and stimulation devices as the wireless energy is being transmitted, wherein the wireless energy comprises an electric, an electromagnetic or a magnetic field, or a combination thereof, or electromagnetic waves, and further comprising implanting in the patient an electric motor or pump operatively connected to the constriction device and directly powering the motor or pump by wireless energy in the form of a magnetic or an electromagnetic field.

151. The method according to claim 147, wherein the wireless energy comprises energy of a first form, further comprising transmitting the energy of the first form into energy of a second form and operating the constriction/stimulation unit with the energy of the second form.

152. The method according to claim 151, wherein the energy of the second form is different than the energy of the first form, the energy of the second form comprises electric energy and the constriction/stimulation unit is directly operated with the energy of the second form in a non-magnetic, non-thermal or non-mechanical manner.

156. The method according to claim 151, wherein the energy of the first form is directly or indirectly transformed into the energy of the second form, further comprising providing a motor for operating the constriction device and powering the motor with the energy of the second form.

157. The method according to claim 156, wherein the constriction device is operable to perform at least one reversible function, further comprising reversing the function by using the motor.

158. The method according to claim 156, further comprising shifting polarity of the energy of the second form to reverse the motor.

159. The method according to claim 156, further comprising directly powering the motor with the transformed energy of the second form, as the energy of the second form is being transformed from the energy of the first form.

160. The method according to claim 151, wherein the wireless energy of the first form comprises sound waves and the energy of the second form comprises electric energy.

161. The method according to claim 151, further comprising implanting in the patient a source of energy for storing the energy of the second form and supplying energy from the source of energy in connection with the operation of the constriction/stimulation unit, wherein the source of energy comprises an accumulator, and wherein the accumulator comprises at least one capacitor or at least one rechargeable battery, or a combination of at least one capacitor and at least one rechargeable battery.

164. The method according to claim 151, further comprising implanting in the patient a source of energy for supplying energy for the operation of at least one of the constriction and stimulation devices and a switch for switching the energy supplied by the source of energy, and using the energy of the second form to operate the switch to switch from an “

off”

mode, in which the source of energy is not in use, to an “

on”

mode, in which the source of energy supplies energy for the operation of the constriction/stimulation unit.

166. The method according to claim 151, further comprising implanting in the patient a stabilizer for stabilizing the energy of the second form, wherein the energy of the second form comprises electric current and the stabilizer comprises at least one capacitor.

168. The method according to claim 147, wherein the wireless energy is transmitted in at least one wireless signal.

169. The method according to claim 168, wherein the signal comprises a wave signal in the form of a sound or ultrasound wave signal, or in the form of an electromagnetic wave signal including one of an infrared light signal, a visible light signal, an ultra violet light signal, a laser signal, a micro wave signal, a radio wave signal, an x-ray radiation signal, and a gamma radiation signal.

172. The method according to claim 168, wherein the signal comprises a digital or analogue signal, or a combination of a digital and analogue signal.

173. The method according to claim 151, wherein the energy of the first form comprises an electric, an electromagnetic or a magnetic field, or a combination thereof.

174. The method according to claim 147, wherein the wireless energy comprises an electric, an electromagnetic or a magnetic field, or a combination thereof, further comprising transmitting the wireless energy in pulses or digital pulses, or a combination of pulses and digital pulses.

175. The method according to claim 151, wherein the energy of the first form is transformed into a direct current or pulsating direct current, or a combination of a direct current and pulsating direct current, or transformed into an alternating current or a combination of a direct and alternating current.

177. The method according to claim 151, wherein one of the energy of the first form and the energy of the second form comprises magnetic energy, kinetic energy, sound energy, chemical energy, radiant energy, electromagnetic energy, photo energy, nuclear energy or thermal energy.

178. The method according to claim 151, wherein one of the energy of the first form and the energy of the second form is non-magnetic, non-kinetic, non-chemical, non-sonic, non-nuclear or non-thermal.

181. The method according to claim 32, wherein the control device comprises a manually operable switch for switching on and off at least one of the constriction and stimulation devices, further comprising subcutaneously implanting the switch in the patient.

194. The method according to claim 32, further comprising implanting in the patient an operation device and operating at least one of the constriction and stimulation devices with the operation device.

195. The method according to claim 194, further comprising providing a magnet and activating the operation device with the magnet, wherein the magnet activates the operation device from outside the patient'"'"'s body.

197. The method according to claim 194, wherein the operation device comprises a motor, further comprising providing a source of energy and powering the motor with energy released from the source of energy.

199. The method according to claim 32, further comprising implanting a source of energy, releasing energy from the source of energy and using the released energy in connection with the operation of at least one of the constriction and stimulation devices wherein the source of energy comprises a battery.

221. The method according to claim 2, wherein step (a) is performed by constricting any penile portions of a series of penile portions of the penile portion'"'"'s tissue wall, respectively.

222. The method according to claim 221, wherein the penile portions of the series of penile portions are constricted in random or in accordance with a predetermined sequence, further comprising constricting the wall portions of the series of wall portions at least two at a time at positions spaced apart on the penile portion.

224. The method according to claim 221, wherein step (b) is performed by stimulating any constricted penile portions of the series of penile portions.

225. The method according to claim 224, wherein the penile portions of the series of penile portions are constricted in random or in accordance with a predetermined sequence, further comprising constricting the wall portions of the series of wall portions at least two at a time at positions spaced apart on the penile portion.

228. The method according to claim 221, wherein step (a) is performed by constricting all of the penile portions of the series of penile portions, and step (b) is performed by stimulating any constricted penile portions in random or in accordance with a predetermined sequence to close the penile portion'"'"'s lumen.

229. The method according to claim 228, wherein the penile portions of the series of penile portions are further constricted by the stimulation device in random or in accordance with a predetermined sequence further comprising constricting the penile portions of the series of senile portions at least two at a time at positions spaced apart on the penile portion.

231. The method according to claim 2, wherein step (a) and step (b) are performed simultaneously or independently of each other.

263. The method according to claim 2, wherein the penile portion is stimulated while the constriction of the penile portion is changed.

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183. The method according to claim 179, wherein the control device comprises a wireless remote control that controls at least one of the constriction and stimulation devices from outside the patient'"'"'s body, wherein the wireless remote control transmits at least one wireless control signal for controlling the constriction/stimulation unit.

186. The method according to claim 183, wherein the control signal comprises a frequency, amplitude, phase modulated signal or a combination thereof, and an analogue or a digital signal, or a combination of an analogue and digital signal.

188. The method according to claim 183, wherein the wireless remote control transmits a carrier signal that carries the control signal, the carrier signal comprising digital, analogue or a combination of digital and analogue wave signals.

191. The method according to claim 183, wherein the control signal comprises an electric or magnetic field or a combined electric and magnetic field, or a wave signal comprising one of a sound wave signal, an ultrasound wave signal, an electromagnetic wave signal, an infrared light signal, a visible light signal, an ultra violet light signal, a laser light signal, a micro wave signal, a radio wave signal, an x-ray radiation signal and a gamma radiation signal.

193. The method according to claim 186, wherein the wireless remote control transmits an electromagnetic carrier wave signal that carries the digital or analogue control signal.

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185. (canceled)

187. (canceled)

189. (canceled)

190. (canceled)

192. (canceled)

196. (canceled)

198. (canceled)

200. (canceled)

201. A method for treating a male impotent patient, the method comprising the steps of:

inserting a needle like tube into a cavity of the patients body,

using the needle like tube to fill the cavity with gas thereby expanding the I cavity,

placing at least two laparoscopical trocars in the patient'"'"'s body,

inserting a camera through one of the trocars into the cavity,

inserting a dissecting tool through any of the trocar and dissecting an area of at least one portion of the tissue wall of the penile portion,

placing a constriction device and a stimulation device in the dissected area in operative engagement with the penile portion,

using the constriction device to gently constrict the penile portion of the penile portion to restrict the venous blood flow in the penile portion, and

using the stimulation device to stimulate the constricted penile portion to cause contraction of the penile portion to further restrict the venous blood flow in the penile portion to achieve erection.

207. The method according to claim 201, wherein the cavity comprises;

at least one of an abdominal cavity, a cavity in the pelvic region, a cavity in human soft tissue, or muscle, or fat or fibrotic tissue.

216. The method according to claim 201, further comprising providing a constriction device that constricts the wall portion for performing step (a), a stimulation device that stimulates the constricted wall portion for performing step (b) and an external source of energy outside the patient'"'"'s body, controlling the external source of energy from outside the patient'"'"'s body to release wireless energy, and using the released wireless energy for operating at least one of the constriction and stimulation devices.

217. The method according to claim 216, further comprising transforming the wireless energy into electrical energy inside the patient'"'"'s body by an implanted energy-transforming device and using the electrical energy in connection with the operation of at least one of the constriction and stimulation devices.

218. The method according to claim 217, further comprising directly using the electrical energy in connection with the operation of at least one of the constriction and stimulation devices, as the transforming device transforms the wireless energy into the electrical energy.

219. The method according to claim 216, further comprising controlling the external source of energy from outside the patient'"'"'s body to release non-magnetic wireless energy, and using the released non-magnetic wireless energy for operating at least one of the constriction and stimulation devices.

220. The method according to claim 216, further comprising controlling the external source of energy from outside the patient'"'"'s body to release electromagnetic wireless energy, and using the released electromagnetic wireless energy for operating at least one of the constriction and stimulation devices.

233. The method according to claim 216, further comprising providing an internal energy source, transmitting said wireless energy from the external energy source located outside the patient and receiving the wireless energy by the internal energy source located inside the patient, the internal energy source being connected to at least one of the constriction and stimulation devices for directly or indirectly supplying received energy thereto, the method further comprising the steps of:

determining an energy balance between the energy received by the internal energy source and the energy used for at least one of the constriction and stimulation devices, and

controlling the transmission of wireless energy from the external energy source, based on the determined energy balance.

234. The method according to claim 233, further comprising inductively transmitting the wireless energy from a primary coil of the external energy source to a secondary coil of the internal energy source.

235. The method according to claim 233, further comprising detecting a change in the energy balance, and controlling the transmission of wireless energy based on the detected energy balance change.

236. The method according to claim 233, further comprising detecting a difference between energy received by said internal energy receiver and energy used for the constriction device and/or stimulation device, controlling the transmission of wireless energy based on said detected energy difference, and decreasing the amount of transmitted wireless energy if the detected energy balance change implies that the energy balance is increasing, or vice versa, wherein the decrease/increase of energy transmission corresponds to a detected change rate.

239. The method according to claim 236, further comprising decreasing the amount of transmitted wireless energy if the detected energy difference implies that the received energy is greater than the used energy, or vice versa, wherein the decrease/increase of energy transmission corresponds to the magnitude of said detected energy difference.

241. The method according to claim 236, further comprising storing the energy used for at least one of the constriction and stimulation devices in at least one energy storage device.

242. The method according to claim 235, wherein substantially all the energy used for at least one of the constriction and stimulation devices is consumed for the operation thereof, further comprising consuming the energy after being stabilized in at least one energy stabilizing unit.

247. The method according to claim 216, further comprising providing an internal energy source located inside the patient connected to at least one of the constriction and stimulation devices for directly or indirectly supplying received energy thereto, determining an energy balance between the energy sent by the external energy source and the energy received by the internal energy source, and controlling the transmission of wireless energy from the external energy source, based on the determined energy balance.

248. The method according to claim 247, further comprising inductively transmitting the wireless energy from a primary coil in the external energy source to a secondary coil in the internal energy source.

249. The method according to claim 247, further comprising detecting a change in the energy balance, and controlling the transmission of wireless energy based on the detected energy balance change.

250. The method according to claim 247, further comprising detecting a difference between the energy sent by the external energy source and the energy received by the internal energy source, and controlling the transmission of wireless energy based on the detected energy difference.

251. The method according to claim 249, further comprising decreasing the amount of transmitted wireless energy if the detected energy balance change implies that the energy balance is increasing, or vice versa, wherein the decrease/increase of energy transmission corresponds to a detected change rate.

253. The method according to claim 250, further comprising decreasing the amount of transmitted wireless energy if the detected energy difference implies that the received energy is greater than the used energy, or vice versa, wherein the decrease/increase of energy transmission corresponds to the magnitude of said detected energy difference.

255. The method according to claim 247, further comprising transmitting said wireless energy by means of a primary coil in the external energy source, inductively receiving the wireless energy by means of a secondary coil of an internal energy source, the internal energy source being connected to a device for directly or indirectly supplying received energy thereto, transferring feedback control information from the secondary coil to the primary coil by switching the secondary coil on and off to induce a detectable impedance load variation in the primary coil encoding the feedback control information, wherein the feedback control information relates to the energy received by the internal energy source, and using the feedback control information to control the transmission of wireless energy from the external energy source.

256. The apparatus according to claim 255, wherein the external energy source further comprises an electronic circuit for comparing the feedback information with the amount of energy transmitted by the external energy source, further comprising analyzing by an analyzer of the electronic circuit the amount of energy being transmitted and the received feedback information related to the amount of energy received in the receiver, determining the energy balance by comparing the amount of transmitted energy and the feedback information related to the amount of received energy, and adjusting by the external energy source the level of said transmitted energy based on the feedback information.

259. The method according to claim 233, further comprising transmitting the wireless energy by means of a primary coil of the external energy source, inductively receiving the wireless energy by means of a secondary coil of the internal energy source, and transferring feedback control information from the secondary coil to the primary coil by switching the secondary coil on and off to induce a detectable impedance load variation in the primary coil encoding the feedback control information, where the feedback control information relates to the energy balance.

260. The method according to claim 216, further comprising placing a coil of an energy-transmission device externally to the human body, placing an energy receiver internally in the human body, placing in the body an electric circuit connected to power the external coil with electrical pulses to transmit the wireless energy, the electrical pulses having leading and trailing edges, using the electric circuit to vary first time intervals between successive leading and trailing edges and/or second time intervals between successive trailing and leading edges of the electrical pulses to vary the power of the transmitted wireless energy, and receiving by the energy receiver the transmitted wireless energy having a varied power.

202. A method for treating a male impotent patient, the method comprising the steps of:

inserting a needle like tube into a cavity of the patients body,

using the needle like tube to fill the cavity with gas thereby expanding the cavity,

placing at least two laparoscopical trocars in the patient'"'"'s body,

inserting a camera through one of the trocars into the cavity,

inserting a dissecting tool through any of the trocar and dissecting an area of at least one portion of the tissue wall of the penile portion,

placing a stimulation device in the dissected area in operative engagement with the penile portion, and

using the stimulation device to stimulate the penile portion to cause contraction of the penile portion to restrict the venous blood flow in the penile portion to achieve erection.

264. The method according to claim 202, wherein the cavity comprises;

at least one of an abdominal cavity, a cavity in the pelvic region, a cavity in human soft tissue, or muscle, or fat or fibrotic tissue.

203. (canceled)

204. A method for treating a male impotent patient, the method comprising the steps of:

cutting the skin of the patient,

inserting a dissecting tool and dissecting an area of at least one portion of the tissue wall of the penile portion,

placing a constriction device and a stimulation device in the dissected area in operative engagement with the penile portion,

using the constriction device to gently constrict the penile portion of the penile portion to restrict the venous blood flow in the penile portion, and

using the stimulation device to stimulate the constricted penile portion to cause contraction of the penile portion to further influence the venous blood flow in the penile portion to achieve erection.

205. A method for treating a male impotent patient, the method comprising the steps of:

cutting the skin of the patient,

inserting a dissecting tool and dissecting an area of at least one portion of the tissue wall of the penile portion,

placing a stimulation device in the dissected area in operative engagement with the penile portion, and

using the stimulation device to stimulate the penile portion to cause contraction of the penile portion to restrict the venous blood flow in the penile portion to achieve erection.

206. (canceled)

208. (canceled)

209. (canceled)

210. (canceled)

211. (canceled)

212. (canceled)

213. (canceled)

214. (canceled)

215. (canceled)

223. (canceled)

226. (canceled)

227. (canceled)

230. (canceled)

232. (canceled)

237. (canceled)

244. The method according to claim 237, further comprising storing the energy used for at least one of the constriction and stimulation devices in at least one energy storage device.

245. The method according to claim 237, wherein substantially all the energy used for at least one of the constriction and stimulation devices is consumed for the operation thereof further comprising consuming the energy after being stabilized in at least one energy stabilizing unit.

238. (canceled)

240. (canceled)

243. (canceled)

246. (canceled)

252. (canceled)

254. (canceled)

257. (canceled)

258. (canceled)

261. The method according to claim 261, further comprising delivering by the electric circuit the electrical pulses to remain unchanged except varying the first and/or second time intervals.

262. The method according to claim 261, wherein the electric circuit has a time constant, further comprising varying the first and second time intervals only in the range of the first time constant, so that when the lengths of the first and/or second time intervals are varied, the transmitted power over the coil is varied.